NPIMap

Individual provider Active NPI

David B Dunn, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1265451199
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036065804 Issued in IL
Practice address
12400 Olive Blvd
#203
Saint Louis, MO 63141-5454
Phone
(317) 878-2100
Fax
(314) 878-2107
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036065804 IL Primary
Phlebology Physician 202K00000X ME102728 FL

Addresses

Primary practice location

12400 Olive Blvd
#203
Saint Louis, MO 63141-5454

Mailing address

1901 Butterfield Rd
Suite 220
Downers Grove, IL 60515-7915
Phone (630) 725-2768

Other identifiers 2

IdentifierTypeStateIssuer
0533210001OtherILDMERC
91307OtherFLBCBS

Other names 1

  • Dr. David Bruce Dunn Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120106000543 MO Practitioner - Family Practice 4688734239 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME102728FLMDPhlebology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Track Medical LLC CurrentSince Sep 9, 2014 Accepting new patients
Fast Track Urgent Care LLC Current Accepting new patients
Fast Track Medical LLC CurrentSince Sep 9, 2014 Accepting new patients
Florida Phlebology Inc Phlebology Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Vein Clinics of Chicago LLC Past Accepting new patients
Skin Care Services, LLC Past Accepting new patients
Illinois Phlebology Associates SC Phlebology PastSince Jun 15, 2011 Accepting new patients
Missouri Phlebology Inc Phlebology Past Accepting new patients

Locations

2686 N Highway 67
Florissant, MO 63033
Phone (314) 436-9300

Interoperability endpoints

  • Direct secure messaging: david.dunn@catc.eclinicaldirectplus.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1265451199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 BUTTERFIELD RD",
            "address_2": "SUITE 220",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605157915",
            "telephone_number": "630-725-2768",
            "fax_number": "630-725-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 OLIVE BLVD",
            "address_2": "#203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415454",
            "telephone_number": "317-878-2100",
            "fax_number": "314-878-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036065804",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "FL",
            "license": "ME102728",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0533210001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "91307",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "DUNN",
            "middle_name": "BRUCE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.